AREXVY

Indicated For

RSV lower respiratory tract disease prevention

About This Medication

# GSK Vaccines Patient Assistance Program Patient Guide: How to Get AREXVY (Respiratory Syncytial Virus Vaccine, Adjuvanted) at Low or No Cost This guide explains how eligible patients can receive **AREXVY**, GSK's adjuvanted vaccine for preventing respiratory syncytial virus (RSV) lower respiratory tract disease, at no cost through the **GSK Vaccines Patient Assistance Program**. Managed by the independent GSK Patient Access Programs Foundation, this program helps adults facing financial barriers access important vaccines like AREXVY without third-party coverage.[2][5] ## About AREXVY **AREXVY** is a single-dose, adjuvanted RSV vaccine approved for adults aged 60 years and older to protect against RSV disease, which can cause severe pneumonia and hospitalization, especially in older adults. It works by stimulating the immune system to produce antibodies against the RSV virus. Administered as an intramuscular injection by a healthcare provider, AREXVY has been shown in clinical trials to reduce the risk of RSV-related lower respiratory tract disease.[1][2] Always consult your doctor to confirm if AREXVY is right for you, as it may not be suitable for everyone due to allergies or medical history. ## Who Qualifies for the Program? The program is designed for financially needy adults without vaccine insurance. Key eligibility criteria include: - **Age**: 18 years or older (note: AREXVY is indicated for 60+).[2] - **Residency**: Live in the United States or Puerto Rico (not eligible if enrolled in or approved for Puerto Rico's Mi Salud plan).[2] - **Insurance**: No third-party coverage for vaccines, including Medicare Part D.[2][3] - **Income**: Household gross income must not exceed specified Federal Poverty Level (FPL) thresholds, typically around 400-500% FPL based on program details.[2] **Income Eligibility Breakdown** | Household Size | Maximum Annual Gross Income | |---------------|-----------------------------| | 1 | $47,880 | | 2 | $64,920 | | 3 | $81,960 | | 4 | $99,000 | | Each additional person | Add $17,040 | These limits are subject to change; your provider will verify during application. No income docs may be needed upfront in some cases, but proof like tax returns or pay stubs could be requested.[2][6] ## Insurance Requirements You **must have no third-party payer coverage for vaccines**. This means: - No private insurance, Medicaid, or other plans covering vaccines. - **Medicare Part D patients are ineligible** for vaccine medicines through this program.[3] - The program does not constitute health insurance and cannot be used with other payers.[1][2] If you have any vaccine coverage, explore that first or confirm denial before applying. ## Step-by-Step Application Process Applications must be submitted **by your healthcare provider**—patients cannot apply directly online.[2] Here's how it works: 1. **Discuss with Your Doctor**: Talk to your healthcare provider about AREXVY and the program. Confirm medical need and lack of coverage. 2. **Provider Registers**: Your prescriber must register at **www.gskpatientassistanceprogramportal.com** (separate for vaccines).[1][2][3] 3. **Complete Forms**: Gather and complete: - **Completed application form** (English/Spanish available).[2] - **Prescriber registration** and signature, certifying medical indication.[1] - **Patient Health and Allergy Information Form**.[2] - Proof of income if requested (e.g., last year's tax return, W-2s, pay stubs).[6] 4. **Submit Application**: Provider faxes to **1-855-474-3063**, mails to PO Box 220590, Charlotte, NC 28222-0590, or submits via provider portal.[1][2] 5. **Phone Support**: Call **1-866-728-4368** (M-F, 8am-8pm ET) for help, forms, or Spanish assistance.[1][2] 6. **Approval**: Once approved, you're eligible for vaccine doses up to **12 months**.[1][2] ## Timeline and Delivery - **Processing Time**: Not specified; obtain approval **before** administering the vaccine to avoid delays.[1][7] - **Delivery**: Vaccines are **shipped directly to your healthcare provider's office** (replenishment shipping address required).[1][3] - **Subsequent Doses**: For multi-dose needs, submit a **Vaccine Dose Authorization Request Form** (DARF) via fax for approval.[2][7] - **Reauthorization**: Required annually; reapply before 12 months expire.[1][6] ## Alternatives if Denied If ineligible: - Check state vaccine programs or Vaccines for Adults (VFA) via CDC. - Contact patient advocacy groups or call 1-866-728-4368 for other GSK resources.[2] - Explore low-cost clinics, community health centers, or manufacturer coupons (if insured).[4] - No biosimilar alternatives for AREXVY exist currently. ## Important Disclaimer This guide is for informational purposes only and not a guarantee of eligibility or coverage. Program terms, income limits, and availability can change; always verify with GSK at 1-866-728-4368 or your provider. Consult your doctor for medical advice. GSK Patient Assistance Program is a charitable foundation program, separate from GSK, and does not constitute health insurance. Subject to eligibility and terms.[1][2][5] (Word count: 942)

Program information last verified: March 30, 2026